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Abstract

Introduction

Intimate partner violence against women is more prevalent in Ethiopia and among the
highest in the world. This study was aimed to explore the attitudes of the community
on intimate partner violence against women, the strategies women are using after the
violence act, and suggested measures to stop or reduce the act in East Wollega Zone.

Methods

A total of 12 focus group discussions involving 55 men and 60 women were conducted
from December, 2011 to January, 2012. Discussants were purposefully selected from
urban and rural settings of the study area. The analyses followed the procedure for
qualitative thematic analysis.

Results

Three themes (attitudes, coping strategies, and suggested measures) were emerged.
Most discussants perceived, intimate partner violence is accepted in the community
in circumstances of practicing extra marital sex and suspected infidelity. The majority
of women are keeping silent and very few defend themselves from the violent husbands/partners.
The suggested measures by the community to stop or reduce women’s violence were targeting
actions at the level of individual, family, community, and society.

Conclusion

In the study community, the attitude of people and traditional norms influence the
acceptability for the act of intimate partner violence against women. Most victims
are tolerating the incident while very few are defending themselves from the violent
partners. The suggested measures for stopping or reducing women’s violence focused
on provision of education for raising awareness at all levels using a variety of approaches
targeting different stakeholders. It is recommended that more efforts are needed to
dispel myths, misconceptions and traditional norms and beliefs of the community. There
is a need for amending and enforcing the existing laws as well as formulating the
new laws concerning women violence including rape. Moreover, providing professional
help at all levels is essential.

Keywords:

Focus group discussion; Women violence; Attitude; Coping; Measures

Background

In patriarchal societies which believe in male dominance the force used by a man to
control his wife is seen as legitimate [1]. Moreover, studies have found that males within patriarchic societies are more violent
towards their wives and children than are males in societies believing in equality
[2]. Ethiopia is one of the patriarchal societies where many rural communities embrace
various types of violence against women (VAW) [3]. Similarly, many rural communities in Ethiopia embrace various types of violence
against women and even claim to have women who go to the point of saying: “If my husband
does not beat me, it means that he does not love me,” and similar other sayings that
justify violence are common [3]. Due to these facts intimate partner violence against women (IPVAW), the most common
forms of VAW is highly prevalent in Ethiopia [4].

Basically, two theories, however, have heavily influenced IPVAW etiology research;
social learning theory, or the idea that violence may be transmitted from one generation
to the next, and the feminist theory, or the idea that male dominance in society affects
interpersonal relationships [5-9]. Whatever the case, several complex and interconnected social and cultural factors
are involved; all of them being manifestations of unequal power relations between
men and women [8,10-13]. Indeed, the majority of researchers on IPVAW have examined and described the associated
factors using socio-ecological model- the dominant one that integrates many other
explanations and widely used in public health operates at the level of individual,
relationship, community and society/country. Among individual level factors the use
of alcohol and none or low educational/economic status are frequently cited. These
factors are associated with both the perpetrators and victims of violence. At the
level of the family male control of wealth, decision-making authority, habits of frequent
marital conflict and significant interpersonal disparities in economic, educational
and employment status are included. Community level factors include women isolation
and lack of social support, community attitudes that tolerate and legitimize male
violence, and poverty. At the level of society: gender roles that entrench male dominance
and female subordination, inadequate laws and policies for the prevention and punishment
of violence, and limited awareness and sensitivity on the part of law enforcement
officials, courts and social service providers are frequently cited.

Community attitudes and actions with respect to IPVAW play an important role in shaping
the social environment in which the victims are embedded. Similarly, the social environment
that contribute either to condone and perpetuate or to reduce levels of IPVAW in the
society plays an important role [14]. Several studies have indicated that a high risk of IPVAW in male-dominant or patriarchal
societies where gender attitudes and perceptions of the community support marked inequality
between men and women in addition to rigid gender roles can lead to justification
and acceptance of IPVAW [15-17]. Other studies have shown that attitude towards IPVAW is one of the most prominent
predictors when compared with other potential factors such as social and empowerment
[18,19]. Attitudes toward infidelity by the female partner were at the other extreme: 60%
of men and 87% of women believed that beating is justified if the woman was sexually
unfaithful [20].

Evidence showed that women use different strategies such as tolerance, temporary or
permanent separations, seeking outside help, or physical self defense from the violent
husbands/partners [21]. In World Health Organizations (WHO) multi-country study on domestic violence and
women’s health conducted in ten countries, for example, the victims kept silent (tolerate)
and the interviewer was the first person to which many victims had ever talked about
their partner’s violence [11]. Similarly, in rural Ethiopia, nearly half of the women had tolerated and didn’t
talk the incident to anybody. Very few (6%) had fought back to defend themselves,
and other 30% had left home on one or more occasions to escape from violent husbands/partners
[3]. In addition, the WHO study confirmed that between 19% and 51% of victims had ever
left home for at least one night and between 8% and 21% reported leaving 2–5 times
[11].

A study on the prevalence, risk factors, and health outcomes of IPVAW on ever married/cohabited
women aged 15–49 years was conducted in the study area. The magnitude and health effects
of IPVAW are all-embracing. The study also identified substantial risk factors for
the occurrences of IPVAW [4]. However, the communities view on IPVAW was not well explored in Ethiopian setting
in general and the study area in particular. Thus, this study is aimed to explore
the community attitude, strategies women are using after the violence act, and the
suggested measures to stop or reduce IPVAW at the study area.

Methods

The study was conducted in one urban and four rural districts in East Wollega Zone,
which is one of the 18 administrative zones of Oromiya National Regional State. East
Wollega Zone is located at the western part of the country 331 km far from Addis Ababa,
Ethiopia. The 2011/12 projected total population of East Wollega zone is 1,610,816
out of which 789, 299 (49%) are males and the rest 821, 516 (51%) are females [22]. Different ethnic groups, such as Oromo, Amhara, Gurage and Tigre are residents of
the zone, out of which 85% of the dwellers were Oromo and ‘Afan Oromo’ is the official and working language [22].

Qualitative (FGD) data was collected between December, 2011 and January, 2012. The
number of focus group discussion was determined by saturation of ideas - until a point
where no more new ideas emerged. A total of 12 focus group discussions comprising
of 115 discussants (55 male and 60 female) was conducted. Four groups were from urban
(two groups of males and two of females) and eight groups were from rural residents
(four groups of males and four of females). The discussants were employees from different
sectors, religious and community leaders, elders and residents of the study area.
Each group consisted of 8–12 participants. The discussants were selected with criteria
of being ever married/cohabited, having not been involved in the previous survey [4] and being not related with each other. They were selected using purposive sampling
method with the support of the local leaders and health care professionals as they
were well familiar with the conditions of the area. The FGDs were categorized by sex,
area of residence and employment statuses to capture heterogeneity among different
subgroups and to allow for homogeneity within a group [23].

Open-ended unstructured and flexible discussion guide was prepared based on the objective
of the study. The discussion guide for the factors involved in the occurrences of
intimate partner violence against women was prepared based on the ecological model
[8] of understanding IPVAW. During data collection and initial analyses, this pre-understanding
was put within brackets [24].

Two trained female research assistants (a social worker and an anthropologist) moderated
the female group activities while the principal investigator and male anthropologist
guided the male groups. One female and one male assistant from the team organized
the FGDs and handled tape recordings. The discussions were tape-recorded and all observations
made were recorded as field notes. The discussions were conducted in a quiet place
to encourage free discussion without any threats and each lasted for 60–90 minutes.

The recorded FGDs were transcribed verbatim in the regional language (Afan Oromo). Later, it was translated into English by the principal investigator together with
the moderators. To assure the validity of the translation, another person, proficient
in both languages checked and commented on it so as to incorporate changes into the
report. Many of the post-FGD questions and interactions were not recorded to include
into the analysis. Following the steps of qualitative thematic content analysis [25-27], the texts were imported into the Open Code 2007 program to facilitate the coding
process [28]. After reading the transcripts, the researchers performed open coding of the texts,
constantly comparing similarities and differences by going back to the original text.
In the next step, selective coding was performed and relevant codes were further conceptualized
leading to the development of categories. Several categories were taken together to
form themes. During the coding process, relevant quotations from transcripts were
put into memos and incorporated to illustrate main ideas during the write-up. Finally,
understanding of multiple forms of information collected and triangulation of different
data sources was made to verify the findings.

The research proposal was examined and screened for scientific and ethical integrity
by the institution’s review board (IRB), the highest body for approving research in
the College of Health Sciences, Addis Ababa University. To this effect, a letter with
green light to carry out the study was issued and an official letter was written to
the regional and local authorities by the school of public health. Formal permission
and verbal consent was secured from administrative officials at different levels of
governmental Authorities and the local community leaders. Furthermore, the ethical
guidelines of VAW research was strictly followed [4]. Informed verbal consent was obtained in advance from the respective FG discussants
to record their responses. They were also told to switch-off the audiotape, if they
feel that there are issues which should not be recorded. The researcher ensured that
all collected information is kept and used in such a manner that confidentiality,
anonymity and privacy of all participants are maintained, bearing in mind the sensitivity
of the topic.

Multidisciplinary research team, verbatim transcriptions, and predefined analytical
procedures were used to promote the study rigor. During the analysis the fitness and
relevance of emerging categories to the research question were tested by constant
comparison and checking between the text, codes and categories. Moreover the Lincoln
and Guba’s model [29] of trustworthiness has been applied. Credibility was assured by continuous interaction
with discussants in the study area. Follow-up interviews with participants were conducted
and member-checking was done to verify the findings. Triangulation of data collection
methods was done as field notes were also used to collect data. Transferability was
enhanced by purposive sampling of the discussants. Detailed and thick/dense description
of results as well as literature control was done to support the findings. Confirmability
was ensured through the use of an independent coder who analyzed the data independently
and a consensus discussion was held to agree on adopted themes and categories [30].

Results and discussion

Results

The number of focus group discussion was determined by saturation of ideas- until
a point where no more new ideas emerged. The saturation point of information has been
reached after the twelfth discussions. A total of 115 discussants (55 men and 60 women)
participated into the discussions. The median age of the discussants is 40.4 years
(range: 23 to 78 years). Details of the socio-demographic characteristics of the discussants
are shown in Table1.

The main themes described during the analysis were: description of violence that occurs
to women from their husbands/partners, explanation on the possible factors leading
to women’s violence and its consequences, community attitudes on IPVAW, women’s response
after the attack, suggested intervention area, the currently available and functional
social and/or legal services at the area, and the current statuses of IPVAW at the
study area. However the main concern of this paper is the analysis of the views of
the community on attitudes on IPVAW, women’s response after the attack, and the suggested
measures to stop or reduce IPVAW. These themes are described by categories, sub-categories, and codes (Table2).

Table 2.Descriptions given for intimate partner violence against women by themes, sub-categories
and selected codes, East Wollega Zone, Western Ethiopia, December 2011 to January
2012

Attitudes of the Community towards Intimate Partner Violence against Women

The traditional tendency that places women in a subordinate position to men has led
to a culture of justification of accepting IPVAW. This act is often justified by men
as a form of control of the family. However, from these FGDs two divergent ideas emerged
on the attitudes towards women violence inflicted from their intimate partners.

Conditions under which the Act of IPVAW Could Be Acceptable

A. Failure to give birth and suspicion for infidelity

The acts of IPVAW could be acceptable by the community if the woman commits extra-marital
sex, is suspected for sexual infidelity (adultery), is always in dispute with her
husband, her neighbors or community members, does not obey the husband/partner, or
fails to give birth under all conditions.

" “…most men cite a paragraph in the bible states the wife has to respect her husband.
They are repeatedly using this saying when they want to attack their wife/partners
in all circumstances like suspecting her for infidelity” (A 37 years religious leader from female group)."

" The society pushes families to have more children even if the woman resists. Commonly
people say “garaan haadhaa qalqalloodha,” which literally means, “mothers’ womb is
like a container” (A 34 year-old woman from prosecutor’s office)."

B. Behaving as controlling and non-domestic women

The community believes in women accusation when they attempt to speak for their own
rights. Most people also stigmatize such women labeling them as deviant, big-headed,
and uncultured. The community also attaches connotative expressions like non-domestic
to such women when they actively participate in public affairs. For example, both
men and women groups noted that people in their community accept wife beating as it
is the appropriate way to correct the women.

" There is a saying, “uleen suphee duwwaa cabsa” to mean, “A stick breaks only a clay
pot.” Mostly elders in this community believe in the importance of stick for controlling
women. Such a traditional belief targets the way a woman dialogues with her husband.
If a woman swears at her husband, it is considered as looking down on him, so he has
to punish her (A 41 year-old man from a rural community)."

Conditions under which the Act of IPVAW Could not Be Acceptable

A. Hair splitting arguments

According to some of the participants, currently there is some degree of change in
the perception of the community on IPVAW. The community is taking different measures
against men who frequently attack their wives or who exhibit a violent behavior. The
majority of the participants from both groups expressed that IPVAW is an intolerable
act, especially if the man commits adultery, is always intoxicated, and always raises
hair split arguments like for instance the dinner is not delicious and the like.

" Most members of our society know that attacking women is a crime. Usually, if the
man raises hair splitting arguments and is always in dispute with his partner, the
act is considered as intolerable. Even if there could be a disagreement between a
husband and a wife, it should not lead to abuse and has to be solved through discussions (A 34 year-old woman from the Education Bureau)."

B. Exclusion from social support system

The majority of participants from the female groups extensively discussed the protection
of the right of women as they are part of the society. Others also mentioned that
if a husband keeps attacking his wife on trivial issues and always quarrels with other
people in the community, he is excluded from the local social support system (edir)
in the form of sanctions.

" …. Despite the traditional roles of men as head of the family, the community considers
women as daughter, sister, wife and mother. For this reason, we do not accept attack
under any circumstances. Occasionally, if the husband keeps attacking his wife on
trivial issues and always quarrels with other people in the neighborhood, the community
rejects his act and excludes him from social affairs like edir. However, to do so,
it should be ensured that the woman has fulfilled the expectations of the husband/partner
and the community, like for example, obeying the husband, giving care for the children,
giving birth, and not having extra-marital sexual relations” (A 46 year-old man, rural education office)."

Women’s Reactions to Intimate Partner Violence (Coping Strategies)

According to the majority of the participants, most women do not report cases of violence
by their intimate partner primarily due to the fact that they may be stigmatized and
ashamed by the community. In some cases, it may result in life of discrimination with
consequences like difficulty in re-marriage. Basically, four sub-themes emerged on
strategies that women use when such an incident occurs in the study area.

A. Tolerance

Most discussants mentioned that their culture dictates women not to go back to their
parents or elsewhere once they got married for they are expected to keep the family
net intact, especially for the welfare of their children. Thus they tend to stay tolerant
of every challenge from their abusive partner.

" …. In the beginning, I used to cry and lock myself up in a room. But now, I gave up,
and I would not leave my husband. I can’t stay away from my kids or make them suffer
without a father figure. They are my life, and I would do anything for them….” This
is the reason why I stay on tolerating violence by my husband (A 33 year-old woman from rural community)."

" I myself passed so many nights in my compound under banana and went back to home in
the morning for the sake of my children (a 27 years female from Nekemte town)."

Furthermore, most women in the study area have no awareness about their rights and
prefer to remain tolerant of everything from the husbands/partners. Some also said
that the traditional norms of the society discourage females not to discuss their
problems with others. In addition, most women live with the principle of “obsuu” and “dhoksuu” which means “remaining patient” and “keeping secret.” This means, females should tolerate and hide the challenges they face from their
partners.

" The tradition itself expects females to be a tolerant wife. That is why “dandeessuu,”
meaning someone with high degree of endurance, is a very common bride’s name given
by the family of the husband at marriage (A 35 year-old man from the Education Bureau)."

The woman as a victim accepts that there is nothing she can do about the abuse. She
accepts that she was just unfortunate to marry an abusive partner but she is prepared
to endure the relationship. A 52 years religious man from rural community noted, “…the woman has made a commitment to their marriage until death. Therefore, she will
not go away”.

B. Leaving home

The discussants from both groups mentioned that most women in the study area, mainly
those in the rural areas, leave home either temporarily or permanently when they feel
they cannot bear the violence any longer. In fact, because of culture and traditional
norms of the society, men are not expected to leave the house. Moreover, court personnel
remarked that most of the time women face severe attacks from their husbands and leave
home with no claim of any property in their home.

" “I was married at age of 15 and lasted for 22 years in marriage. In this stay I left
my home and went back to my parents for about 20 times. My mother said me “what do
the community says about us when you come back to us from your husband. So you have
to go to him.” She sends me back when elders come without talking about the problems
I encountered there (A 37 years from urban)."

" In my vicinity, a husband and a wife were always in dispute during the night time.
She shouted every time he came drunk and started annoying her. She always went to
his relatives and came back after things cooled down. But one day, he severely attacked
her on the back and she was admitted to a hospital. After she recovered, she permanently
left home and went back to her family with no appeal to the legal system (A 61 year-old man from the urban)."

The court personnel extended their idea that most of the time women face severs attack
from their husbands and leave home without giving care for their property in their
home. In this regard, when both partners come to the court system and the woman win,
the husband sends local elders for mediation and she lifts her appeal with the pressure.

C. Self-defence

Few women in the area resort to physical confrontations to have their rights respected
and protect themselves from harsh physical or verbal attack. This was reflected in
the discussions among urban respondents.

" …. Let me share you my personal experience. After long time tolerance and weeping,
I tried to beat him to defend myself when he severely attacked me on the stomach (A 29 year-old house wife, urban)."

A religious leader from the rural community also said:

" …. I have seen a woman in my locality that goes to the extent of injuring his genital
organ with knife after several disputes. The woman took this measure for self-defense
because the man has become addicted to violent behaviour (A 57 years religious leader from rural community)."

D. Seeking help/telling others

Most victims, as a first measure, usually go to the local/village elders, relatives,
or close friends for arbitration. In fact, these people often advise the couple to
tolerate each other. But if the case is not settled, they resort to more formal structures
such as the kebele social court, women’s affairs, police or court system. Even then, there are a number
of cases where these women are not taken serious because of influence from long standing
traditions of the community. The cases below attest to such practices.

A judge from the rural area expressed his experience on a case where a woman sued
her husband for beating her. There, the judge asked the man, “Why did you beat your
wife violating her right?” Then the husband replied, “Respected judge, I did not beat her on the right, but on her left side.”

In this regard, the women groups draw attention to the fact that females are excluded
from the local elders for arbitration of disputes between couples in their community.
For instance one of the female group discussants said,

" .… One day, I went to take part in the local elders group to mediate disputed couples.
In the group there were seven males and I was the only female. I was unfortunately
late to arrive and they were waiting for me. In fact, they did not know me and were
expecting the eighth male. But when I arrived, they were surprised and angrily remarked,
“We wasted our time waiting a woman” (A 46 year-old woman from the urban)."

Most participants extensively claimed that women are not allowed to be members of
an arbitration group. This implies that decisions made usually favour males. The mediators
mostly pressurize females to accept their decision no matter how much she was victimized.
Moreover, how women are treated by the police officers was an issue of lively discussion
among female participants.

" “A woman went to the police office to sue her husband. The investigator was a policeman
who had three co-habitants. He sent the woman to local elders advising her not to
waste her time. He said, “Abbaa manaaf haadha manaa sireetu araarsa” literally meaning,
the bed mediates between a husband and a wife. This is a problem. The problem is not
the issue of policy but its implementations” (A 34 year-old woman from Women’s Affairs Office)."

Since women are not allowed to be parts of arbitrators, the decisions are usually
biased towards males. They usually pressurize females to accept their decision no
matter how she is victim of the conflict. Members of the community use proverb which
encourage females’ inferiority. For instance,

Community Suggested Measures

The other theme emerged was community’s perception towards measures taken to stop
IPVAW. Other sub-categories were observed after selective coding of measures to be
taken at the levels of individual, family, community, and society was made.

A. At an individual level

In most discussions, the first measure should focus on intensive provision of formal
and informal education for females on their legal rights and problems of cohabitation.
Moreover, the majority of the participants suggested that the concerned bodies (religious
institutions and municipality) should provide premarital, sexual and family life education.

" …women have to be advised on not simply co-habiting with a man without thorough scrutiny
of him as this problem is pervasive in the area. Pre-marital education should be provided
by the concerned bodies like the municipality and religious leaders” (A 39 year-old woman from the local court)."

B. At family level

Advising the couple to discuss all family issues in a gentle and courteous way was
briefly raised in all groups. They emphasized that a husband and a wife should have
respect for each other from the very beginning, because once a dispute occurred between
the couple, it becomes difficult to manage. They also stressed the importance of teaching
the couple about their income, family problems and the need for one of the couple
to try to calm the other down when she becomes temperamental. They said a family issue
should be discussed and solved within the family.

" Since family is a base for the community and eventually for the country, solving a
family problem has to be the responsibility of all citizens. Tolerance is the major
mechanism of reducing violence between couples. As an Oromo proverb goes, “obsaan
aannan goromsaa dhuga” meaning, “Someone tolerant drinks the milk of the heifer” (implying
this is the best milk) to indicate the importance of tolerance in the family. Behaving
this way solves problems related with alcoholism and temperament (A 49 year-old male community leader)."

C. At community level

Most discussants stressed the importance of formal social support like government
assistance programs and criminal justice, and informal assistance by the local elders,
friends, relatives and others.

" According to the custom of the area, before any further step, elders look into the
dispute between couples for more than three times. If they fail to resolve the problem,
then the case is taken to the court. However, because the custom is highly valued,
the court could even send it back to the local elders before making a legal decision.
This is the procedure we follow. In the community, elders are responsible for thoroughly
investigating cases and giving advice to the wrongdoer and mediate the couple (A 45 year–old male from Prosecutor’s Office)."

To stop or reduce IPVAW, it is prudent to educate the whole community. Changing the
attitudes of the society regarding the rights of the women is another working area
for everybody in the community. If couple have thought sitting together, they can
understand for each other and improve their behavior; they can openly discuss every
issue and hence reduce the chance of getting dispute. Also it is better to use religious
institutions, local social support system like edir, schools and other relevant places
to teach the society.

" The best solution is increasing the community’s awareness using media and forums.
In addition, schools should teach about gender issues from the very beginning so that
the generation can be changed (A 78 years local community elder)."

" Some community members are against the act of violence and still there are some individuals
who can give approval for such acts. To balance the community responses, awareness
creation and awareness rising should be given on gender issues through media and religious
institutions on continuous bases (A 42 years male from justice office)."

All groups emphasized the importance of collaboration among different organizations
for stopping or reducing IPVAW. The behavioral change strategy should be focusing
on everyone in the community.

" ….last week a man injured an eye of a woman who owns a grocery. She came to our office
for help and we directed her to the police. But a group followed and warned her saying,
“If you withdraw your appeal, he will pay you compensation, but if you proceed, you
will lose all your customers.” She accepted the second option. I personally met one
of the members of the group mediating the case and asked him why they interfered.
He replied, “Harree fi dubartiin duruu ni reebamti, maal ho’ista?” which means, “It
is a tradition for the women and donkeys to be beaten, so why do you exaggerate?” (A 47 year old woman from an NGO)."

Particularly the rural discussants gave emphasis for providing equal services for
all people in the community irrespective of their economical status and ethnicity.

" “…when rich and well to do families are in dispute, the community interfere and tries
to mediate them as early as possible. But when poor family like me is in dispute and
females are in problem no one interferes and tries to mediate. In addition, poor families
cannot be a member of local social support (edir) as they do not afford the monthly
contribution. Basically such social supports is formed by members of the local villages
and lead by elders for helping people in all aspects and interfere and/or mediate
the family dispute (A 40 years daily laborer female)."

D. At society/country level

Some participants in this study pointed out that much is expected of all organizations
in general and the implementing agencies in particular. It is important to hire experts
on family and marriage issues equipped with knowledge of family mediation. Others
also suggested that the government should amend or codify acceptable evidences in
investigating violent acts because many people complain that the criminal code of
Ethiopia demands eyewitness from three people and medical certificate from health
institutions to decide that the offender is guilty. For instance, in cases of rape,
it is impossible to have eyewitness as the act takes place in a hidden environment.

" There is a gap between policy on the paper and its implementations. For instance if
we take the so called women’s’ associations, they are not properly working. Even at
some places they do not have sufficient knowledge on the issue itself. As a result
they are not successful in mobilizing women to attend different awareness rising forums.
On the other hand, the legal bodies ask eye witness for serious criminal act like
rape (A 47 years old male from education office)."

" The law of the land and the police demand that the victim produce evidences like witnesses
from at least three people and medical certificate from health institutions. This
is not right. What is expected of the victim should be reporting the case. Investigating
the issue should be the job of the police, because such attacks take place in secret
so that the victim cannot produce evidence(A 29 year-old women from the Education Bureau)."

In addition, they recommended that concerned bodies like the police officers, experts
in women’s affairs, the prosecutor and judges be equipped with appropriate knowledge
and skills necessary to handle such cases. Additionally, there should be legal protection
for the victim so that the offender does not attack again or revenge. Majority of
the participants suggested that the court establish a special center that works on
GBV and emphasize on empowering women.

" When we think about the solution, we have to think about who is responsible. Who should
be involved? As the problem is complex, it needs the involvement of different stakeholders.
Concerned bodies should work to practically implement the gender policy of the country
and draft new laws or amend the existing ones to make them appropriate to deal with
violence against women (A 36 year-old female from Social Affairs Office)."

Discussions

The first theme explains the divergent idea of the community towards IPVAW. The sub-categories
for the second theme on women response includes tolerance, temporary or permanent
separation, seeking outside help, and physical/verbal self defenses. Thirdly, the
theme on the measures to be taken to stop or reduce IPVAW was focusing the activities
at individual, family, community, and country levels.

The majority of the discussants have mixed and divergent feelings to express the community
attitudes on IPVAW. Some justified the accusation of women by their husbands if she
committed extra marital sexual affairs. This goes with the finding from other similar
study justified wife beating triggered by an action that is socially unacceptable
like sexual infidelity [31]. Similarly the EDHS of 2005 indicated that the majority of women believed for a husband
to be justified in beating his wife at least for one reason if she is: not completing
housework on time, refused sex, disobeying her husband, being unfaithful or questioning
him about his extra-marital relationships [32]. These all implies the traditional norms place women in a subordinate position to
men and have led to a culture of justification of IPVAW. However, some of the discussants
were claiming the act of wife abuse to be a criminal act because currently it is given
attention by the government.

The majority of the discussants assured the victims in their community are living
with their abusive partners tolerating the incident. This could be justified as lack
of awareness of the women about their rights. Moreover, the influence of traditional
believes and norms in their area are more pronounced. This is similar with the findings
from Spain that showed high level of women violence tolerance was associated with
low awareness about their rights [14]. The reason why abused women hide violent attacks to their children, family, friends,
and neighborhood is to avoid outside interference and later reprisal from the abuser
which forces the victim to prefers and live with the abusive partner silently. Women
often considered it as a shameful to share such personal problems with others [33]. For example, previous study from rural Ethiopia showed nearly half of the women
kept silent after the violent attack from their intimate partners [3]. This explains why many women do not discuss violence with anyone else that indicates
either they consider it normal feature of life or ashamed of revealing the violence.

In most cases the victim primarily tries to report the incident to their relatives,
close friends, or local elders for advice and support. But these depend on the severity
of the violent act that ranges from verbal threats to severe physical aggression.
This finding goes with the result from Nicaragua which indicated that the woman’s
decision to seek help may be triggered by specific incidents like when attacked severely,
affecting the children welfare, and destroying properties [21].

In the study area few women, especially from urban are fighting against their abusive
husbands/partners either physically or verbally in order to protect themselves. This
is in contrast with finding from Nepal and Nicaragua where the majority of the women
reported in defending themselves from abusive partners [21,34]. However, it is corroborating the finding from rural Ethiopian showed only six percent
of the victims had fought back to defend themselves from the violent husbands/partners
[3]. In Ethiopian context, it is evident that fighting back to the husbands is not culturally
accepted and thus it is shameful for the woman to hit her husband though, this by
itself could be one strategy in minimizing damage from abusive partners.

Some women mainly from the rural go to their relative house and to a lesser extent
to friends or neighbors. This goes with the study result from Butajira, Ethiopia indicated
about one in three women left their home either temporarily or permanently because
of the incident [3]. Actually some culture specific factors that are related with the practice of women
leaving home or staying somewhere without their partner can determine this strategy.
This depends on the availability of places of safety for women and their children.
However, ending a relationship does not necessarily reduce a woman’s risk, as some
partners become even more violent when women leave or attempt to leave the relationships
[35].

The suggested measures for stopping or reducing IPVAW are targeting the factors described
in the ecological model for the occurrences of IPVAW at the levels of individual,
relationships/family, community, and society/country [8]. This is because of the fact that IPVAW is a multifaceted issue with psychological,
social and environmental roots [36]. According to their suggestions the measures require a variety of approaches targeted
different stakeholders, including government and nongovernmental agencies, law enforcement
agencies, the health and education sectors, the line ministries such as the women
affairs, and other faith based organizations (FBOs). Their suggestions are in line
with the recommendations from other similar studies from around the world [3,21,31,37].

Currently there are several institutions which deal specifically with Gender Based
Violence (GBV), including Women’s Affairs Offices (federal, regional, district (the
lower administrative unit) and in some cases kebele (the lowest administrative unit in Government structure) level), the judiciary system
(police, prosecutors office and court), health institutions, Ethiopian Women’s Lawyers
Association (EWLA), women’s associations and schools. However, the effectiveness of
these institutions to prevent intimate partner violence against women, mitigate its
impact and enforce the laws has been reduced due to a number of factors, including
limited capacity of the institutions, attitudes of the personnel, accessibility and
affordability of the services including the quality of services provided to the community
and lack of knowledge by women about the existence of such institutions. The community
suggested measures also support these notions.

As to the strengths of this study, we have used a multi-dispensary research team.
Moreover, the methodological efforts to achieve diverse and representative sample
of discussants from the community and the rigor of the coding and analysis phases
are meticulously applied. We also think that the discussions were open and free. However,
concerning the limitation, as any other qualitative researches the study results may
not be generalized to all other areas of the country. Despite this, we believe that
this study has contributed a deeper understanding and knowledge for people in this
field and similar area.

Conclusion

The study found that the majority of the discussants stated as the victim uses silence
or tolerating the violent husbands/partners. This is clearly due to the traditional
norms and attitudes of the community towards IPVAW. The study also showed, very few
victims can defend themselves from the violent husbands/partners. Biased arbitration
is marked excluding women from elders in the arbitration or mediation system. The
penal code of the country has a loophole for supporting the rape cases that requests
permissible or tangible evidences, since the act of rape is always committed secretly
or behind closed door. It is recommended that more efforts are needed to dispel myths,
misconceptions and beliefs that condone IPVAW. For mitigating IPVAW influencing personal
relationships and creating healthy family environment is needed by all stake holders.
Providing professional help and support at all levels as well as for the families
who are already experiencing the act is also crucial. There is a need for amending
and enforcing the existing laws as well as formulating the new laws concerning rape.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

All three authors were responsible for the design and conduct of the study. Coding
and interpretation of findings and drafting of the manuscript were done by the three
authors. The authors read and approved the final content of the manuscript.

Authors' information

GS is working as lectures in departments of Reproductive Health, Population and Nutrition,
School of Public Health, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
FM is a professor of Public Health working in departments of Reproductive Health,
Population and Nutrition, School of Public Health, Addis Ababa University, Addis Ababa,
Ethiopia. WA is a statistician working in departments of Epidemiology and Biostatistics,
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

Acknowledgement

We are very much grateful to Addis Ababa University and Bill and Melinda Gates Institute,
John Hopkins University for funding the study. Our thanks also go to Geremew Huluka
and Thige G/Mariam for their generous efforts during data collection and transcription.
The study discussants are appreciated for their willingness to participate in the
research.

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